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Ob-Gyn Coding Alert

Infertility:

Fed Up With Initial Infertility Visit Denials? Symptoms Beyond 628.9 Could Make the Difference

Published on Wed Feb 09, 2011

Warning: If you have to ask yourself if your documentation is "ethically" correct, then it probably isn't.If a patient presents to your practice complaining she is unable to get pregnant, you shouldn't automatically assume that you'll be sacrificing payer reimbursement for this visit. Focusing on symptoms rather than 628.9 (Infertility, female; of unspecified origin) can make all the difference in how payers view your claims.Get to the Crux of the ProblemMost insurance carriers will not reimburse for infertility treatments, and many payers balk when the word "infertility" pops up."Infertility services always require intensive review prior to a patient's visit," says Cheryl Ortenzi, CPC, billing and compliance manager of BUOB/Gyn in Boston. "In most cases, coverage is very specific. You have to verify coverage or lack thereof and review that with the patient so that everyoneunderstands who is paying for these services."Good advice: Collect payment up-front for either the whole procedure [...]
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